Saturday, October 20, 2012

Scherz On Disincentives

In particular, he notes that ObamaCare will increasingly reward doctors for cutting costs and skimping on care to patients.

Under IPAB, ACOs, "bundled payments", and the other new regulations, doctors will be encouraged to not practice medicine, rather than to practice medicine. For instance:

Obamacare creates a template which will result in the elimination of the
private practice of healthcare. This will occur through Accountable
Care Organizations (ACOs) which are large hospital systems employing
physicians, ostensibly to facilitate the integration of care and to
control costs.

Sadly, ACOs are akin to the HMOs of the 1990s, only much
worse. The payment for an episode of care comes into the ACO as a single
bundled payment and the institution determines how the money is
divided. The patient no longer is the first priority of the doctors, but
rather, it is satisfying the needs of their boss- the ACO. Doctors will
be incentivized to save money- doing less, not more for their patients.
Currently, less than 50% of doctors are self-employed and this number
will drop sharply under Obamacare.

Under these pressures, many doctors will quit or retire early. Others will just ramp down their efforts, working fewer hours. We'll see fewer doctors willing to put in the extra effort staying late in the medical library consulting a journal to nail a difficult diagnosis or fine tune a patient's treatment protocol.

Instead, more and more doctors will develop a clock-puncher mentality, like we see at the local DMV office. After all, why should they make that extra effort for you, the patient, when their bosses don't want them to?

If you don't want that kind of doctor taking care of you in a few years, the time to speak up is now.

About FIRM

America was founded on the principles of freedom and individual rights. Applied to medicine, the law must respect the individual rights of doctors and other providers, allowing them the freedom to practice medicine. This includes the right to choose their patients, to determine the best treatment for their patients, and to bill their patients accordingly. In the same manner, the law must respect the individual rights of patients, allowing them the freedom to seek out the best doctors and treatment they can afford.

Freedom and Individual Rights in Medicine (FIRM) promotes the philosophy of individual rights, personal responsibility, and free market economics in health care. FIRM holds that the only moral and practical way to obtain medical care is that of individuals choosing and paying for their own medical care in a capitalist free market. Federal and state regulations and entitlements, we maintain, are the two most important factors in driving up medical costs. They have created the crisis we face today.

Freedom and Individual Rights in Medicine was founded by Lin Zinser and Paul Hsieh, MD in 2007. It is now managed by Paul Hsieh, MD.